Is your LTC facility primed for HIT implementation and training?

October offers many crucial conferences relevant to long-term care, including those of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), the national LeadingAge/Center for Aging Services Technology, the Home Care Technology Association of America (HCTAA) and the American Society of Clinical Pathology (ASCP).

At many of those meetings, health information technology (HIT) will be at the root of robust sessions and conversations. In this blog, I’ll discuss one of the most important stages of HIT implementation—Stage 6, Implementation and Training.

In review, the 10 recommended stages are:

1. Draft HIT Clinical Strategic Plan
2. Clinical Workflow Process Analysis
3. Update HIT Clinical Strategic Plan
4. HIT Infrastructure Due Diligence
5. HIT Clinical Design
6. Implementation and Training
7. Partnerships and Risk Management
8. Person Centric Longitudinal Care
9. Algorithms and Alerts
10. Preferred LTPAC Provider in your care community

When it comes to Stage 6, I am sorry to say that the traditional way to deal with “implementation and training” is to place all of your faith in your IT vendor. Doing so usually results in automating your previous paper or electronic workflows but not updating the clinical and business workflows that will be required for the future person-centric longitudinal care.

To be frank, Stage 6 cannot be taken lightly, and you cannot rely on the vendor to do the workflow analysis without your active participation. Taking a passive approach to this stage often leads to providers using only part of the capabilities the HIT system offers. Many times I have encountered a healthcare provider site that has not stayed current on its vendor’s application updates, and then wondered why the HIT system did not have a certain capability—only to discover the capability was installed but not kept updated.  

The IT vendors do an excellent job of working with your facilities and staff to develop the basic workflows to use their applications, with the goal of providing a higher level of care. But, there is work to be done by you, ideally before you start implementation, or else prior to training on the HIT system. Some vendors include workflow analysis prior to starting the training and implementation, which can be a great help; especially if your staffers have a good grasp of the future community role of long-term care/post-acute care (LTPAC) within your facility or agency. As I’ve discussed before, you have to have a future vision within our healthcare evolution. The difficulty is to develop workflows that continue to provide today’s care while simultaneously thinking and understanding what will be needed in the future.

My suggestion is to look at workflows from two different perspectives: First, look at today’s requirements, and second, look at the perspective of the person-centric longitudinal model and the “transitions of care” aspects. The largest difference is in viewing clinical and business information over time, with trending in mind instead of just episodic care events. I encourage you to think through both clinical and business workflows.

On a different topic: I attended a National Quality Forum (NQF) eMeasure Learning Collaborative meeting in September where we examined eQuality measures across the spectrum of care. NQF is working towards the harmonization of all quality measures, which is very important to synchronizing longitudinal care.

Also, on October 1, the national penalty-based initiatives began on reducing re-hospitalizations. A very important role for LTPAC providers is to start working and partnering with hospitals. Good working relationships will also accelerate transitions of care between hospitals and skilled nursing facilities and home care agencies. On Sepotember 27, the Centers for Medicare & Medicaid Services announced a new program to increase quality of care in nursing homes.

Meanwhile, everyone is digesting the final rule on Meaningful Use Stage 2 and starting the planning on Stage 3 of the HITECH Act. I continue to urge you to get involved with the association HIT committees and the S&I Framework Longitudinal Coordination of Care Committee.